| NPI | 1417366196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 007038) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05011448A) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2017-03-08 |